Audit Management

Manage audit processes while addressing vulnerabilities and protecting revenue.

Optum™ Audit Management provides a single software solution for managing compliance with multiple medical claims audits conducted by government and commercial health care plans.

Our Audit Management solutions provide dashboards and administrative tools that help hospitals efficiently manage steps in the audit process from the time they are notified to completion of the claims review. It also enables users to examine their current and historical claims data to identify claims that may trigger an audit, locate and resolve the source of errors and take action to reduce the chance of future reviews. This configurable solution was designed specifically to meet Medicare and other payer requirements, including RAC, MAC/FI ADR and probes, CERT audits, MIC audits, and other Medicaid and commercial audits.

Audit Management can help you effectively handle Recovery Audit Contractor (RAC) and prevent future RAC take-backs using claim edits on known target issues. It allows you to assess potential risk, manage the audit and appeal processes, monitor deadlines, identify root causes and calculate net financial impact. 

Key benefits:

  • Manage both audits and appeals.
  • Quantify risk and get insight into root causes of problems.
  • Reduce future take-backs and protect revenue.
  • Minimize audit costs.
  • Accelerate audit resolution and improve documentation request tracking.